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Electroencephalography in syncope

R P Brenner1

  • 1University of Pittsburgh, Pennsylvania, USA.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|May 1, 1997
PubMed
Summary
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Electroencephalography (EEG) shows similar patterns in various syncope types, reflecting reduced brain blood flow. Simultaneous electrocardiography (ECG) is crucial for accurate diagnosis in loss of consciousness evaluations.

Area of Science:

  • Neurology
  • Cardiology

Background:

  • Syncope, or fainting, has diverse causes including neurocardiogenic, neurologic, cardiac, and orthostatic hypotension.
  • Electroencephalography (EEG) is often used to evaluate episodes of loss of consciousness.

Purpose of the Study:

  • To review and summarize Electroencephalographic (EEG) findings in patients experiencing syncope.
  • To highlight the utility of simultaneous Electrocardiography (ECG) in differentiating syncope from epilepsy.

Main Methods:

  • Review of existing literature on EEG findings in various syncope categories.
  • Analysis of EEG patterns associated with cerebral hypoperfusion.
  • Comparison of clinical presentations and EEG findings in syncope versus epileptic seizures.

Main Results:

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  • Regardless of syncope cause, EEG findings consistently indicate cerebral hypoperfusion, progressing from background rhythm slowing to delta activity and eventual flattening.
  • Convulsive syncope, a non-epileptic event, can occur during EEG flattening due to severe ischemia and may be misdiagnosed as epilepsy.
  • Epileptic disorders can sometimes mimic syncope, necessitating careful diagnostic evaluation.

Conclusions:

  • EEG findings in syncope are primarily indicative of cerebral hypoperfusion, irrespective of the underlying etiology.
  • Simultaneous ECG monitoring during EEG is essential for accurate diagnosis in patients presenting with loss of consciousness, helping to distinguish syncope from epilepsy.